Decision-making for bilateral risk-reducing mastectomy for an increased lifetime breast cancer risk: A qualitative metasynthesis.

Autor: Torrisi C; Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri, USA., Wareg NK; Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri, USA., Anbari AB; Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri, USA.
Jazyk: angličtina
Zdroj: Psycho-oncology [Psychooncology] 2024 Mar; Vol. 33 (3), pp. e6311.
DOI: 10.1002/pon.6311
Abstrakt: Objective: Previvor is a term applied to a person with an identified, elevated lifetime cancer risk but without an actual cancer diagnosis. Previvorship entails the selection of risk management strategies. For women with a genetic mutation that increases their predisposition for a breast cancer diagnosis, bilateral risk-reducing mastectomy (BRRM) is the most effective prevention strategy. However, BRRM can change a woman's breast appearance and function. The purpose of this qualitative metasynthesis (QMS) was to better understand the decision-making process for BRRM among previvors.
Methods: A theory-generating QMS approach was used to analyze and synthesize qualitative findings. Research reports were considered for inclusion if: (1) women over 18 years of age possessed a genetic mutation increasing lifetime breast cancer risk or a strong family history of breast cancer; (2) the sample was considering, or had completed, BRRM; (3) the results reported qualitative findings. Exclusion criteria were male gender, personal history of breast cancer, and research reports which did not separate findings based on cancer diagnosis and/or risk-reduction surgery.
Results: A theory and corresponding model emerged, comprised of seven themes addressing the decision-making process for or against BRRM. While some factors to decision-making were decisive for surgery, others were more indefinite and contributed to women changing, processing, or suspending their decision-making for a period of time.
Conclusions: Regardless of the decision previvors make about BRRM, physical and psychosocial well-being should be considered and promoted through shared decision-making in the clinical setting.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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